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Sanjay Saint - One of the best experts on this subject based on the ideXlab platform.
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sustainability of a program to reduce unnecessary Urethral Catheter use at a veterans affairs hospital
Infection Control and Hospital Epidemiology, 2021Co-Authors: Karen E. Fowler, Sarah L Krein, David Ratz, Debbie Zawol, Sanjay SaintAbstract:We assessed the long-term sustainability of a quality improvement intervention to reduce Urethral Catheter use at a Veterans Affairs (VA) hospital. During the 8 years after the initial intervention, point-prevalence surveillance showed that Urethral Catheter use continued to decrease (OR, 0.91; 95% CI, 0.86-0.97; P = .003) and that appropriateness of Catheter use remained unchanged.
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reducing unnecessary Urethral Catheter use in japanese intensive care units a multicenter interventional study
Infection Control and Hospital Epidemiology, 2019Co-Authors: Akira Kuriyama, Karen E. Fowler, Jennifer Meddings, Hiromasa Irie, Daisuke Kawakami, Hiroshi Iwasaki, Masaaki Sakuraya, Kohta Katayama, Yasuharu Tokuda, Sanjay SaintAbstract:We conducted a preintervention-postintervention study to assess the effectiveness of a multimodal approach to reduce unnecessary Urethral Catheters in 5 Japanese intensive care units. After the intervention Urethral Catheter point prevalence decreased by 18%, from 79% preintervention to 61% postintervention, and Catheter appropriateness increased by 28%, from 57% preintervention to 85% postintervention.
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A Multicenter Study of Patient-Reported Infectious and Noninfectious Complications Associated With Indwelling Urethral Catheters.
JAMA internal medicine, 2018Co-Authors: Sanjay Saint, Karen E. Fowler, David Ratz, Barbara W. Trautner, John Colozzi, Erica Lescinskas, John M. Hollingsworth, Sarah L KreinAbstract:Importance Indwelling Urethral Catheters (ie, Foley Catheters) are important in caring for certain hospitalized patients but can also cause complications in patients. Objective To determine the incidence of infectious and noninfectious patient-reported complications associated with the indwelling Urethral Catheter. Design, Setting, and Participants A prospective cohort study of consecutive patients with placement of a new indwelling Urethral Catheter while hospitalized at 1 of 4 US hospitals in 2 states. The study was conducted from August 26, 2015, to August 18, 2017. Participants were evaluated at baseline and contacted at 14 days and 30 days after insertion of the Catheter about complications associated with the indwelling Urethral Catheter and how Catheterization affected their social activities or activities of daily living. Exposures Indwelling Urethral Catheter placement during hospitalization. Patients were enrolled within 3 days of Catheter insertion and followed up for 30 days after Catheter placement, whether the Catheter remained in or was removed from the patient. Main Outcomes and Measures Infectious and noninfectious complications associated with an indwelling Urethral Catheter as well as how the Catheter affected patient social activities or activities of daily living. Results Of 2967 eligible patients, 2227 (75.1%) agreed to participate at 1 of 4 study sites; 2076 total patients were evaluated. Of these, 71.4% were male; mean (SD) age was 60.8 (13.4) years. Most patients (1653 of 2076 [79.6%]) had short-term Catheters placed for surgical procedures. During the 30 days after Urethral Catheter insertion, 1184 of 2076 patients (57.0%; 95% CI, 54.9%-59.2%) reported at least 1 complication due to the indwelling Urethral Catheter. Infectious complications were reported by 219 of 2076 patients (10.5%; 95% CI, 9.3%-12.0%), whereas noninfectious complications (eg, pain or discomfort, blood in the urine, or sense of urinary urgency) occurred in 1150 patients (55.4%; 95% CI, 53.2%-57.6%) (P
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a multicenter study of patient reported infectious and noninfectious complications associated with indwelling Urethral Catheters
JAMA Internal Medicine, 2018Co-Authors: Sanjay Saint, Karen E. Fowler, David Ratz, Barbara W. Trautner, John Colozzi, Erica Lescinskas, John M. Hollingsworth, Sarah L KreinAbstract:Importance Indwelling Urethral Catheters (ie, Foley Catheters) are important in caring for certain hospitalized patients but can also cause complications in patients. Objective To determine the incidence of infectious and noninfectious patient-reported complications associated with the indwelling Urethral Catheter. Design, Setting, and Participants A prospective cohort study of consecutive patients with placement of a new indwelling Urethral Catheter while hospitalized at 1 of 4 US hospitals in 2 states. The study was conducted from August 26, 2015, to August 18, 2017. Participants were evaluated at baseline and contacted at 14 days and 30 days after insertion of the Catheter about complications associated with the indwelling Urethral Catheter and how Catheterization affected their social activities or activities of daily living. Exposures Indwelling Urethral Catheter placement during hospitalization. Patients were enrolled within 3 days of Catheter insertion and followed up for 30 days after Catheter placement, whether the Catheter remained in or was removed from the patient. Main Outcomes and Measures Infectious and noninfectious complications associated with an indwelling Urethral Catheter as well as how the Catheter affected patient social activities or activities of daily living. Results Of 2967 eligible patients, 2227 (75.1%) agreed to participate at 1 of 4 study sites; 2076 total patients were evaluated. Of these, 71.4% were male; mean (SD) age was 60.8 (13.4) years. Most patients (1653 of 2076 [79.6%]) had short-term Catheters placed for surgical procedures. During the 30 days after Urethral Catheter insertion, 1184 of 2076 patients (57.0%; 95% CI, 54.9%-59.2%) reported at least 1 complication due to the indwelling Urethral Catheter. Infectious complications were reported by 219 of 2076 patients (10.5%; 95% CI, 9.3%-12.0%), whereas noninfectious complications (eg, pain or discomfort, blood in the urine, or sense of urinary urgency) occurred in 1150 patients (55.4%; 95% CI, 53.2%-57.6%) (P < .001). Women were more likely to report an infectious complication (92 of 594 [15.5%] women vs 127 of 1482 [8.6%] men; P < .001), while men were more likely to report a noninfectious complication (869 of 1482 [58.6%] men vs 281 of 594 [47.3%] women; P < .001). Restrictions in activities of daily living (49 of 124 patients [39.5%]) or social activity (54 of 124 [43.9%]) were commonly reported by the patients who had Catheters still in place; sexual problems were reported by 99 of 2034 patients (4.9%) after their Catheter was removed. Conclusions and Relevance Noninfectious complications of Urethral Catheters affect a substantial number of patients, underscoring the importance of avoiding Urethral Catheterization whenever possible. Given the high incidence of these patient-reported complications, Urethral Catheter-associated noninfectious complications should be a focus of surveillance and prevention efforts.
Gregory P Zagaja - One of the best experts on this subject based on the ideXlab platform.
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early removal of Urethral Catheter with suprapubic tube drainage versus Urethral Catheter drainage alone after robot assisted laparoscopic radical prostatectomy
The Journal of Urology, 2014Co-Authors: Sandip M Prasad, Michael C Large, Amit R Patel, Olufenwa Famakinwa, Matthew R Galocy, Theodore Karrison, Arieh L Shalhav, Gregory P ZagajaAbstract:Purpose: Retrospective single institution data suggest that postoperative pain after robot-assisted laparoscopic radical prostatectomy is decreased by early removal of the Urethral Catheter with suprapubic tube drainage. In a randomized patient population we determined whether suprapubic tube drainage with early Urethral Catheter removal would improve postoperative pain compared with Urethral Catheter drainage alone.Materials and Methods: Men with a body mass index of less than 40 kg/m2 who had newly diagnosed prostate cancer and elected robot-assisted laparoscopic radical prostatectomy were included in analysis. Block randomization by surgeon was used and randomization assignment was done after completing the urethrovesical anastomosis. In patients assigned to suprapubic tube drainage the Urethral Catheter was removed on postoperative day 1 and all Catheters were removed on postoperative day 7. Visual analog pain scale and satisfaction questionnaires were administered on postoperative days 0, 1 and 7.Res...
Karen E. Fowler - One of the best experts on this subject based on the ideXlab platform.
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sustainability of a program to reduce unnecessary Urethral Catheter use at a veterans affairs hospital
Infection Control and Hospital Epidemiology, 2021Co-Authors: Karen E. Fowler, Sarah L Krein, David Ratz, Debbie Zawol, Sanjay SaintAbstract:We assessed the long-term sustainability of a quality improvement intervention to reduce Urethral Catheter use at a Veterans Affairs (VA) hospital. During the 8 years after the initial intervention, point-prevalence surveillance showed that Urethral Catheter use continued to decrease (OR, 0.91; 95% CI, 0.86-0.97; P = .003) and that appropriateness of Catheter use remained unchanged.
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Catheter management after benign transUrethral prostate surgery: RAND/UCLA Appropriateness Criteria.
The American journal of managed care, 2019Co-Authors: Ted A. Skolarus, Casey A. Dauw, Karen E. Fowler, Jason Mann, Steven J. Bernstein, Jennifer MeddingsAbstract:Objectives To formally assess the appropriateness of different timings of Urethral Catheter removal after transUrethral prostate resection or ablation. Although Urethral Catheter placement is routine after this common treatment for benign prostatic hyperplasia (BPH), no guidelines inform duration of Catheter use. Study design RAND/UCLA Appropriateness Methodology. Methods Using a standardized, multiround rating process (ie, the RAND/UCLA Appropriateness Methodology), an 11-member multidisciplinary panel reviewed a literature summary and rated clinical scenarios for Urethral Catheter duration after transUrethral prostate surgery for BPH as appropriate (ie, benefits outweigh risks), inappropriate, or of uncertain appropriateness. We examined appropriateness across 4 clinical scenarios (no preexisting Catheter, preexisting Catheter [including intermittent], difficult Catheter placement, significant perforation) and 5 durations (postoperative day [POD] 0, 1, 2, 3-6, or ≥7). Results Urethral Catheter removal and first trial of void on POD 1 was rated appropriate for all scenarios except clinically significant perforations. In this case, waiting until POD 3 was deemed the earliest appropriate timing. Waiting 3 or more days to remove the Catheter for patients with or without preexisting Catheter needs, or for those with difficult Catheter placement in the operating room, was rated as inappropriate. Conclusions We defined clinically relevant guidance statements for the appropriateness of Urethral Catheter duration after transUrethral prostate surgery. Given the lack of guidelines and this robust expert panel approach, these ratings may help clinicians and healthcare systems improve the consistency and quality of care for patients undergoing transUrethral surgery for BPH.
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reducing unnecessary Urethral Catheter use in japanese intensive care units a multicenter interventional study
Infection Control and Hospital Epidemiology, 2019Co-Authors: Akira Kuriyama, Karen E. Fowler, Jennifer Meddings, Hiromasa Irie, Daisuke Kawakami, Hiroshi Iwasaki, Masaaki Sakuraya, Kohta Katayama, Yasuharu Tokuda, Sanjay SaintAbstract:We conducted a preintervention-postintervention study to assess the effectiveness of a multimodal approach to reduce unnecessary Urethral Catheters in 5 Japanese intensive care units. After the intervention Urethral Catheter point prevalence decreased by 18%, from 79% preintervention to 61% postintervention, and Catheter appropriateness increased by 28%, from 57% preintervention to 85% postintervention.
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A Multicenter Study of Patient-Reported Infectious and Noninfectious Complications Associated With Indwelling Urethral Catheters.
JAMA internal medicine, 2018Co-Authors: Sanjay Saint, Karen E. Fowler, David Ratz, Barbara W. Trautner, John Colozzi, Erica Lescinskas, John M. Hollingsworth, Sarah L KreinAbstract:Importance Indwelling Urethral Catheters (ie, Foley Catheters) are important in caring for certain hospitalized patients but can also cause complications in patients. Objective To determine the incidence of infectious and noninfectious patient-reported complications associated with the indwelling Urethral Catheter. Design, Setting, and Participants A prospective cohort study of consecutive patients with placement of a new indwelling Urethral Catheter while hospitalized at 1 of 4 US hospitals in 2 states. The study was conducted from August 26, 2015, to August 18, 2017. Participants were evaluated at baseline and contacted at 14 days and 30 days after insertion of the Catheter about complications associated with the indwelling Urethral Catheter and how Catheterization affected their social activities or activities of daily living. Exposures Indwelling Urethral Catheter placement during hospitalization. Patients were enrolled within 3 days of Catheter insertion and followed up for 30 days after Catheter placement, whether the Catheter remained in or was removed from the patient. Main Outcomes and Measures Infectious and noninfectious complications associated with an indwelling Urethral Catheter as well as how the Catheter affected patient social activities or activities of daily living. Results Of 2967 eligible patients, 2227 (75.1%) agreed to participate at 1 of 4 study sites; 2076 total patients were evaluated. Of these, 71.4% were male; mean (SD) age was 60.8 (13.4) years. Most patients (1653 of 2076 [79.6%]) had short-term Catheters placed for surgical procedures. During the 30 days after Urethral Catheter insertion, 1184 of 2076 patients (57.0%; 95% CI, 54.9%-59.2%) reported at least 1 complication due to the indwelling Urethral Catheter. Infectious complications were reported by 219 of 2076 patients (10.5%; 95% CI, 9.3%-12.0%), whereas noninfectious complications (eg, pain or discomfort, blood in the urine, or sense of urinary urgency) occurred in 1150 patients (55.4%; 95% CI, 53.2%-57.6%) (P
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a multicenter study of patient reported infectious and noninfectious complications associated with indwelling Urethral Catheters
JAMA Internal Medicine, 2018Co-Authors: Sanjay Saint, Karen E. Fowler, David Ratz, Barbara W. Trautner, John Colozzi, Erica Lescinskas, John M. Hollingsworth, Sarah L KreinAbstract:Importance Indwelling Urethral Catheters (ie, Foley Catheters) are important in caring for certain hospitalized patients but can also cause complications in patients. Objective To determine the incidence of infectious and noninfectious patient-reported complications associated with the indwelling Urethral Catheter. Design, Setting, and Participants A prospective cohort study of consecutive patients with placement of a new indwelling Urethral Catheter while hospitalized at 1 of 4 US hospitals in 2 states. The study was conducted from August 26, 2015, to August 18, 2017. Participants were evaluated at baseline and contacted at 14 days and 30 days after insertion of the Catheter about complications associated with the indwelling Urethral Catheter and how Catheterization affected their social activities or activities of daily living. Exposures Indwelling Urethral Catheter placement during hospitalization. Patients were enrolled within 3 days of Catheter insertion and followed up for 30 days after Catheter placement, whether the Catheter remained in or was removed from the patient. Main Outcomes and Measures Infectious and noninfectious complications associated with an indwelling Urethral Catheter as well as how the Catheter affected patient social activities or activities of daily living. Results Of 2967 eligible patients, 2227 (75.1%) agreed to participate at 1 of 4 study sites; 2076 total patients were evaluated. Of these, 71.4% were male; mean (SD) age was 60.8 (13.4) years. Most patients (1653 of 2076 [79.6%]) had short-term Catheters placed for surgical procedures. During the 30 days after Urethral Catheter insertion, 1184 of 2076 patients (57.0%; 95% CI, 54.9%-59.2%) reported at least 1 complication due to the indwelling Urethral Catheter. Infectious complications were reported by 219 of 2076 patients (10.5%; 95% CI, 9.3%-12.0%), whereas noninfectious complications (eg, pain or discomfort, blood in the urine, or sense of urinary urgency) occurred in 1150 patients (55.4%; 95% CI, 53.2%-57.6%) (P < .001). Women were more likely to report an infectious complication (92 of 594 [15.5%] women vs 127 of 1482 [8.6%] men; P < .001), while men were more likely to report a noninfectious complication (869 of 1482 [58.6%] men vs 281 of 594 [47.3%] women; P < .001). Restrictions in activities of daily living (49 of 124 patients [39.5%]) or social activity (54 of 124 [43.9%]) were commonly reported by the patients who had Catheters still in place; sexual problems were reported by 99 of 2034 patients (4.9%) after their Catheter was removed. Conclusions and Relevance Noninfectious complications of Urethral Catheters affect a substantial number of patients, underscoring the importance of avoiding Urethral Catheterization whenever possible. Given the high incidence of these patient-reported complications, Urethral Catheter-associated noninfectious complications should be a focus of surveillance and prevention efforts.
Lars B. Wadström - One of the best experts on this subject based on the ideXlab platform.
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Long‐term Urethral Catheter drainage and bladder capacity
Neurourology and Urodynamics, 2005Co-Authors: Peter Kristiansen, Rolf Pompeius, Lars B. WadströmAbstract:Bladder capacity has been registered with incremental water cystometry in 399 paticnts with continuous long-term Urethral Catheter drainage. The duration of cathcter drainage varied from a few weeks to 15 years. The real bladder capacity was assessed by abolishing bladder overactivity, when present, with an IM injection of 50 mg emepronium bromide. Bladder capacity was reduced with increasing duration of Catheter drainage. and the relation was statistically significant (p < 0.001). During the first year of Catheter drainage there was a fast reduction of real bladder capacity by 12 mlimonth from 360 ml to 220 ml; during the next 8 years a further reduction by 0.8 rnllrnonth to around 150 ml was registered. The significance of this process in the daily care of the patients was evaluated with a questionnaire to the nursing staff. Bladder overactivity, and to a minor degree. reduction of real bladder capacity caused an increased frequency of urinary leakage beside the Catheter but influenced neither the frequency of change of Catheter nor the discomfort of the patients.
Riccardo Autorino - One of the best experts on this subject based on the ideXlab platform.
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supra pubic versus Urethral Catheter after robot assisted radical prostatectomy systematic review of current evidence
World Journal of Urology, 2018Co-Authors: Riccardo Bertolo, Andrew Tracey, Prokar Dasgupta, Bernardo Rocco, Salvatore Micali, Giampaolo Bianchi, Lance J Hampton, Ash Tewari, Francesco Porpiglia, Riccardo AutorinoAbstract:Purpose To provide latest evidence on the use of suprapubic Catheter (SPC) versus Urethral Catheter (UC) after robot-assisted laparoscopic radical prostatectomy (RARP).
